Dear Dr. Poses,
Sorry for my poor command of English.
I know of the famous definition of EBM by David L. Sackett.
But the statement is unrefutable. ie, not scientific statement
in terms of Karl Popper's way. But to define EBM precisely
has not so much merit to clinical settings.
By the name of EBM, one Japanese authority scammed
goverment subsidies and arrested in this February.
Those who insist scientific or clinical importance
of their own works claims "my work is based on EBM
methodology" which implicate rather "my work is important
because it is almost perfect truth of medicine".
Not few academics earn money , get promoted
by claiming EBM. But those technocratic dimension
of EBM is not what we hope for EBM.
Again, I think to proceed EBM movement is vitally important
for modern society, but the political dimension of EBM
decays EBM mind. EBM itself is born conscientiously,
but wolves roaming around bited a big hole at EBM.
regards
Saio
----- Original Message -----
From: "Roy Poses" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, May 24, 2002 4:26 AM
Subject: Re: THE PHILOSOPHICAL BASIS (fwd)
> On Thu, 23 May 2002 11:27:12 +0900 you said:
> >
> >What I want to say is one should NOT insist everybody
> > must be obedient to evidence derived from EBM methodology
> > because they are invincible truth.
>
> I agree, certainly. But has anyone seriously been arguing that EBM
> provides perfect truth? I would think most EBM enthuisiasts at best would
> argue that EBM is a workable way to apply our best approximate notions of
> truth to patient care to optimize as best we can the patients' outcomes.
>
> >The truth is Evidence is relatively true in terms of clinical
> >pragmatism. Evidence is NOT impregnable, and we cannot
> >force to patients to obey directions of doctors because they
> > have evidence-base.
>
> Again, I doubt many people on this list would advocate forcing patients to
> obey doctors' directions under any but the most extreme circumstances
(e.g.,
> delirious and confused patients with life-threatening illneses, perhaps.)
>
> There seem to be many misconceptions floating around about what EBM is.
It
> might be worth looking at the section "What EBM is Not" in "Evidence Based
> Medicine" by Sackett et al. EBM is not cook-book medicine, rather it
> "it requires a bottom-up approach that integrates the best external
evidence
> with individual clinical expertise and patient choice." (from that
section.)
>
>
> ---------------------------------------------------------
> Roy M. Poses MD
> Brown University Center for Primary Care and Prevention
> Memorial Hospital of RI
> 111 Brewster St.
> Pawtucket, RI 02860
> USA
> 401 729-2383
> fax: 401 729-2494
> [log in to unmask]
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